Text of e-mail sent by Skip Weber: I understand that the gap between celebrex and vioxx is widening again. I have been told that scripts are now 56% to 44% and total market share over the last month is 64% to 36%.

I spoke myself to a Zimbabwe AIDS specialist recently who says in one area 60% of all pregnant women are now infected with HIV. It is not enough just to look at seroprevalence rates however. Take a group of 100 college leavers in Uganda, aged 22. Their seroprevalence rate is falling because of behaviour change but may still be 20% in some groups. That means one in five will probably be dead in 5-10 years. However, the even bigger question is what the LIFETIME seroprevalence rate will be?

The following was written after consultation meetings with NGOs in Calcutta, Bombay, Delhi and Manipur, March 1997, including visits to the sick and dying in rural areas and discussions with commercial sex workers.

India is about to be hit by the world's worst AIDS epidemic, as a country of almost a billion people. Soon there could be more people infected there with HIV than in the whole of Africa today, more cases perhaps by 2005 than the whole world has today. While many industrialised nations have chosen to ignore the devastation in Africa, the unfolding catastrophe in the Far East is already touching many other nations. It will have an obvious and significant effect on the world economy, threatening tiger economies and discouraging investment, with a heavy toll on the health of the workforce.

HIV protease inhibitors offer new hope of a combined approach to HIV infection. Results in some cases have been spectacular with undetectable levels of HIV achieved for long periods. This has raised talk of perhaps even being able to eradicate HIV altogether, based on the fact that many infected cells have a limited life-span. By preventing viral replication one could in theory reach a situation where all infected cells had died.

23 million men have used Viagra since 1988, including 900,000 in the UK. Although few serious side effects have been seen, recent reports (2005) suggest a possible risk of blindness from non-arteritic ischaemic optic neuropathy. This is a rare condition in which blood supply is reduced to the optic nerve causing permanent nerve damage, and research workers at the University of Minnesota believe they have detected a cluster of cases of blindness from this cause in men who have taken Viagra.

The US Food and Drug Administration has also identified 50 men with blindness who have taken Viagra, but who also had diabetes and heart disease. However these problems with blindness need to be seen in the context of 23 million users, most of which have experienced significant benefit to their sex lives, and the fact that blindness is a known risk in those with both diabetes and cardiovascular disease.

AIDS in Africa. How to stop AIDS in Africa. The truth about AIDS in Africa. The History of AIDS in Africa. Huge number of useful links on AIDS in Africa. Economic impact of AIDS in Africa. Orphans and HIV treaments. Read on....

When it seems that every newspaper report on AIDS is saying something different it is hardly surprising that our patients are confused about AIDS. They could be forgiven for coming to the conclusion that HIV is harmless, heterosexual AIDS is a myth, that a cure or vaccine is just around the corner and that promiscuity is safe. (article for Nucleus, Christian Medical Fellowship 1994).

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